Updated on February 6, 2024
7 min read

How Alcohol Affects the Brain

Chronic alcohol consumption can lead to structural and functional changes in the brain. These changes can increase the risk of developing conditions like depression and anxiety.

Heavy alcohol consumption can also potentially contribute to cognitive impairment, memory deficits, and mood disorders. Regularly drinking four or more alcoholic drinks per day also increases a person’s risk of brain shrinkage almost six times compared to non-drinkers.10

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The following factors determine to what extent alcohol negatively impacts the brain:

  • How often and how much alcohol one drinks
  • When you started drinking alcohol
  • Your general healthcare status
  • Gender
  • Genetics
  • Family history
  • Education level
  • Age
  • If you are at risk of prenatal alcohol exposure

Alcohol and Brain Chemistry

Binge drinking interrupts the brain’s communication pathways by flooding it with endorphins and dopamine, two of the brain's "reward" chemicals. However, despite feeling temporary relief, even moderate drinkers don’t experience true health benefits.

The brain’s reward center becomes overloaded, leading to cravings when the alcohol wears off. With enough alcohol consumed, the brain becomes dependent on it to produce these brain chemicals, leading to mood disorders.

Between 20 to 67 percent of cases of drug or alcohol abuse are tied to bipolar disorder and depression.7 Therefore, excessive drinking can lead to both short- and long-term psychological issues.

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How Does Alcohol Affect The Brain?
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How Does Alcohol Affect the Brain in the Short-Term?

When a person drinks alcohol regularly, it can adversely affect the brain, especially in the prefrontal cerebral cortex and cerebellum.

The prefrontal cortex is associated with executive functions such as planning and decision-making. The cerebellum is connected to balance and motor function.

Chronic alcohol misuse affecting these parts of the brain can result in various neurological consequences. Some of these side effects and problems include:

  • Memory problems
  • Mental confusion
  • Decreased muscle reflex response and poor coordination
  • Reduced cognitive performance
  • Vision impairments
  • Trouble focusing
  • Lack of confidence
  • Mood swings
  • Stress
  • Difficulties multitasking
  • Impacted alertness
  • Slurred speech
  • Troubled thoughts
  • Blackouts

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How Does Alcohol Affect the Brain in the Long-Term?

Studies indicate a link between chronic alcohol consumption and long-term neurological complications. Alcohol can cause the hippocampus to shrink if consumed habitually over a long period, even in small amounts. The hippocampus is the area of the brain responsible for memory and learning.

The reasons for this brain disorder are unclear. Research from the Boston University School of Public Health shows that alcohol consumption causes dehydration. Consistent dehydration can have adverse effects on sensitive tissue.

Other studies suggest that the brains of alcoholics are lighter than those who do not have a drinking problem.5 Some of the damage can be reversed if the person decides to stop drinking.

Alcohol’s Effects During Pregnancy

Heavy drinking while pregnant can lead to fetal alcohol syndrome (FAS). Children born with FAS have a range of abnormalities, particularly related to intelligence.

The mean IQ of someone with FAS is 79 - significantly lower than the average IQ of 100.8

FDA Recommendations on Alcohol Consumption

According to FDA recommendations, you can enjoy alcoholic drinks responsibly by maintaining moderate consumption.

Moderate alcohol consumption is defined as:

  • One drink per day for women
  • Up to two drinks per day for men

Keep in mind that even moderate drinking can cause significant consequences. These include the following:

  • Higher chance of developing depression or an anxiety disorder
  • Higher risk of committing suicide
  • Increased alcohol tolerance—this results in heavier drinking to achieve the same effect
  • Increased risk of developing alcohol use disorder (AUD)
  • Irregular brain development
  • Permanent changes to brain chemistry
  • Permanent memory loss
  • Reduced learning ability
  • Impaired judgment
  • Loss of fine motor skills and slower reaction time
  • Weakened immune system

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Common Memory Disorders Associated With Alcohol

Alcohol consumption limits the brain’s ability to transfer information from short-term to long-term memory. When the body absorbs alcohol, the substance alters your neurons, which results in smaller brain cells.

Over time, and with excessive alcohol use, it becomes more difficult to remember previous experiences and simple daily tasks. Additionally, long-term alcohol use is linked to many serious memory disorders.

A few common disorders include:

1. Widespread Brain Atrophy

Alcohol intake shrinks a person’s brain and decreases the size of brain cells.5 Heavy drinkers appear to have smaller brains than moderate and non-drinkers.

Symptoms of brain atrophy include:

  • Changes in mood, personality, or behavior
  • Confusion
  • Amnesia
  • Difficulties with judgment or abstract thinking
  • Difficulty in learning and cognitive functions

2. Wernicke-Korsakoff Syndrome

Some researchers believe Wernicke and Korsakoff syndromes are separate yet related disorders. Others believe them to be different stages of the same disorder or disease spectrum.

Wernicke syndrome is considered the acute phase with a shorter duration and more serious symptoms. Korsakoff syndrome is considered the chronic phase and is a long-lasting condition.

Both of these conditions develop suddenly due to thiamine deficiency. In many cases, those with AUD are deficient in vitamin B1. So they have a higher risk of developing these disorders.

Wernicke syndrome is characterized by disorientation, loss of coordination (ataxia), and eye abnormalities. Affected people may not display all three symptoms.

Other signs of Wernicke’s include:

  • Sudden disorientation and trouble balancing
  • Excessive weight loss and malnutrition
  • Muscle paralysis in the eyes

3. Korsakoff Syndrome

If Wernicke’s syndrome is left untreated, Korsakoff syndrome will likely develop. Korsakoff psychosis forms due to permanent damage in critical small areas deep within the brain.

Korsakoff syndrome is characterized by memory impairment, specifically short-term amnesia (i.e., the inability to form new memories). In some cases, affected people may also have random loss of long-term memories or even experience false memories (confabulation).

4. Alcoholic Dementia

Similar to Korsakoff syndrome, alcohol-related dementia is a form of alcohol-related brain damage that results in memory loss.

Symptoms of Korsakoff syndrome are typically more severe than those of alcoholic dementia.

The symptoms include:

  • Amnesia
  • Personality changes
  • Impaired executive functioning (planning, organizing, and abstract thinking)
  • Visuospatial problems (ex: inability to copy a clock)
  • Difficulty following simple instructions (ex: cooking recipes)
  • Physical unsteadiness or lack of coordination  
  • Slowed reflexes
  • Inability to recognize sounds, tastes, and smells
  • Confusion
  • Loss of speech

Mental Health Disorders and Alcohol

Chronic drinking directly impacts brain function and alters your brain chemistry (neurotransmitters). It also affects your body's hormonal systems and can cause or exacerbate mental health problems.

Due to alcohol’s depressive effect, heavy use raises the risk of suicide and self-harm.

Common mental health disorders associated with heavy alcohol use include:

1. Depression

Depression, a group of conditions that lower a person’s mood, affects about 80 percent of alcoholics at some point. It comes in many forms, including clinical depression and bipolar disorder.

The effects of alcohol can come in waves throughout life. Since alcohol is a depressant, the substance enhances the symptoms of depression due to its sedative effects.

2. Anxiety Disorders

Alcohol-induced anxiety is separate from an independent anxiety disorder, but they are often hard to differentiate.

The symptoms of alcohol-induced anxiety usually appear during alcohol withdrawal. They also tend to resolve quickly with treatment and continued abstinence.

Certain anxiety disorders, including social phobia, PTSD, and panic disorder, have an increased co-occurrence with alcohol dependence. Many people abuse alcohol to suppress the symptoms of their anxiety disorder temporarily.

What many people don't know is that alcohol abuse makes anxiety worse. Alcohol use also has high rates of producing panic attacks, which can turn into panic disorder.

3. Self-Harm and Suicide

Many people drink alcohol to self-medicate. However, alcohol is a depressant. It is linked to many mental health disorders, such as depression.

As a result, the risk of self-harm is high among alcoholics. This may include self-inflicted injuries such as cutting or suicide.

If you or a loved one is self-harming or considering suicide, it is essential to seek medical advice as soon as possible. People with AUD are 60 to 120 times more likely to participate in self-harm and commit suicide than those free from psychiatric illness.11

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Drinking too much alcohol can cause cognitive impairments and lead to brain damage. Binge drinking can cause memory problems, impair judgment and learning abilities, increase the risk of developing a mental illness, and weaken the immune system. 

For the brain to function properly, the FDA recommends consuming alcohol in moderation. If you feel you’re at risk of suicide due to heavy drinking, consult a mental health professional. A doctor can recommend the appropriate treatment program and prescribe addiction medicine.

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Updated on February 6, 2024
11 sources cited
Updated on February 6, 2024
  1. Alcohol's Damaging Effects on the Brain.” National Institute on Alcohol Abuse and Alcoholism, U.S. Department of Health and Human Services, 2004.
  2. Korsakoff's Syndrome.” Alzheimer's Society.
  3. Merz, B. “This Is Your Brain on Alcohol.” Harvard Health Blog, 2017.
  4. Mental Health Issues: Alcohol Use Disorder and Common Co-occurring Conditions.” National Institute on Alcohol Abuse and Alcoholism, 2023.
  5. Ritchie, C., and Koshy, A. “Faculty of 1000 Evaluation for Moderate Alcohol Consumption as Risk Factor for Adverse Brain Outcomes and Cognitive Decline: Longitudinal Cohort Study.” Post-Publication Peer Review of the Biomedical Literature, 2018.
  6. Symptoms of Alcoholic Dementia.” Alzheimer's Society.
  7. Quello et al. “Mood Disorders and Substance Use Disorder: A Complex Comorbidity.” Science & Practice Perspectives, 2005.
  8. Rogne et al. “Intelligence, alcohol consumption, and adverse consequences. A study of young Norwegian men.” Scandinavian Journal of Public Health, 2021.
  9. Crews, F. “Alcohol-Related Neurodegeneration and Recovery.” Alcohol Research & Health: The Journal of the National Institute on Alcohol Abuse and Alcoholism, 2008.
  10. Topiwala et al. “Moderate alcohol consumption as risk factor for adverse brain outcomes and cognitive decline: longitudinal cohort study.” The British Medical Journal, 2017.
  11. Pompili et al. “Suicidal behavior and alcohol abuse.” International Journal of Environmental Research and Public Health, 2010.

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